Cardiovascular System Chapter 17 Slide 2 Cardiovascular System
Cardiovascular System circulates blood continuously thought the
body to deliver oxygen and nutrients to the bodys organs and tissue
and to dispose of waste. Heart (pump) and vasculature (plumbing)
The heart is composed of: Cardiac muscle Atria Ventricles Valves
Cardiac arteries and veins Electrical conduction system Cardiac
Nerves Problems or failure of any of these system can lead to
serious health concerns. Review Anatomy Slide 3 Figure 17.3
Structural components of the heart. Slide 4 Heart Heart pump
composed of synchronized structures Cardiac Vessels Coronary
Arteries extensive network of arteries supplying the heart Coronary
Veins network for venous blood drainage Conduction system heart has
it own conduction system which can initiate and transmit an
electrical impulse via cardiac muscle fibers This electrical charge
stimulates muscular contraction of the heart SA node, AV node,
Bundle of His, Right and Left Bundle Branch Block, and Purkinje
fibers Nerves Sympathetic stimulate the heart, increases heart
rate, force of contraction, and dilation of coronary arteries.
Parasympathetic opposite effect CNS influences the activation and
interaction of nerves through information supplies by the cardiac
plexus. Slide 5 Cardiac Musculature Heart Muscle Base Apex point of
maximum impulse so heart beat is more easily palpated over the apex
5 th intercostal space Three Layers: Epicardium outer layer
Myocardium thick muscular layer Endocardium - smooth inner lining
of chambers Slide 6 Chambers Chambers in the Heart 4 chambers Left
and right atria receiving chambers for blood and pump blood into
the ventricles Left and right ventricles eject blood into vessels
Slide 7 Valves Valves - Permit the Flow of Blood Between Chambers
and into Blood Vessels Atrioventricular (AV) Tricuspid Mitral
Semilunar Pulmonary Aortic Slide 8 Heart Sounds Heart Sounds
Closure of valves which are associated with the contraction and
relaxation phases of the heart. Systole refers to ventricular
contraction and begins with closure of the AV valves (S1) and ends
with the closure of the aortic and pulmonic valve (S2) Diastole
refers to ventricular relaxation and begins with closure of the
aortic and pulmonic valve (S2) and ends with closure of AV valves
(S1). S1 (lub) S2 (dub) Slide 9 Figure 17.5 Heart sounds in systole
and diastole. Slide 10 Table 17.3 Distinguishing Heart Murmurs
Slide 11 Table 17.3 (continued) Distinguishing Heart Murmurs Slide
12 Table 17.4 (continued) Classifications of Heart Murmurs Slide 13
Circulation of Heart Pulmonary Circulation carries deoxygenated
blood to the lungs, where carbon dioxide is exchanged for oxygen.
Systemic Circulation supplies freshly oxygenated blood to the bodys
periphery carrying oxygen and nutrients to cells. Slide 14
Electrocardiogram Electrocardiogram (EKG) - Paper Recording of
Deflections That Represent the Cardiac Cycle Signifies electrical
conduction Electrical deflections P wave PR interval QRS interval T
wave Slide 15 Figure 17.11 Electrocardiogram wave. Slide 16 Cardiac
Function Stroke volume - Amount of blood that is ejected with each
heartbeat Cardiac output - Amount of blood ejected from the left
ventricle over one minute Cardiac index - Measurement accounting
for an individual s weight when evaluating the pumping action of
the heart Slide 17 Landmarks for Cardiac Assessment Sternum
Clavicles Ribs Second through fifth intercostal spaces Correlating
assessment findings over body landmarks provides vital information
related to underlying pathologic mechanisms. Slide 18 Figure 17.18
Landmarks in precordial assessments. Slide 19 Inteview General
Questions Specific Questions Illness Symptoms Behaviors Infants and
children Pregnant female Older adult Environment Slide 20 Equipment
Examination gown Examination drape Stethoscope Metric rulers
Doppler Slide 21 Techniques Physical Assessment of the
Cardiovascular System Techniques Inspection Palpation Percussion
Auscultation Slide 22 Specific Areas Specific Areas of the
Cardiovascular Assessment Inspection of the face, lips, ears, and
scalp Skin color Movement Earlobe creases Inspection of the jugular
veins Pulsations Distention Inspection of the carotid arteries
Pulse characteristics Inspection of the hands and fingers Color
Shape of fingers Slide 23 Figure 17.17 Splinter hemorrhage. Slide
24 Specific Areas Inspection of the chest, abdomen, legs, and
skeletal structure Landmarks Right sternal border, 2 nd intercostal
space Left sternal border, 2 nd intercostal space Left sternal
border, 3 rd 5 th intercostal space Heaves and lifts Slide 25
Palpation Palpation of the chest, including the following
Precordium at the right and left second intercostal spaces Left
third intercostal space Left fourth intercostal space Left fifth
intercostal space at the midclavicular line Position patient at a
30 degree angle or less No thrills, heaves or lifts should be
palpated in any of the five locations Slide 26 Figure 17.19
Landmarks for palpation of the chest. Slide 27 Palpation Carotid
pulses (sequentially) Client may be supine or sitting upright
Asses: Presence diminished or absent may indicate carotid disease
or dissecting aortic aneurysm Strength should be strong but not
bounding Rhythm regular pattern Equality consistent bilaterally
Palpate each artery separately may obstruct blood flow to the
brain, resulting in severe bradycardia or asystole Slide 28 Figure
17.20 Palpating the carotid artery. Slide 29 Percussion Percussion
of the chest for cardiac border 5 th intercostal space at the left
anterior axillary line Normal findings would be resonance because
you will be over lung tissue Next, percuss the mid clavicular line
and the left sternal border Should change to dull as you percuss
over the heart Advance to the 3 rd and 2 nd intercostal space on
the left side. Should change from resonnance to dullness as you
percuss over the heart Slide 30 Figure 17.21 Percussing the chest.
Slide 31 Auscultation Auscultation of the chest using the diaphragm
and bell in various positions to include the following locations
Aortic area at the right second intercostal space S2 is louder than
S1 Pulmonic area at the left second intercostal space S2 is louder
than S1 Erb s point at the left third intercostal space S1 and S2
are heard equally Tricuspid area at the left fourth intercostal
space S1 is louder than S2 Apex at the left fifth intercostal space
at the midclavicular line S1 is louder than S2 Slide 32 Figure
17.22 Auscultating the chest over five key landmarks. Slide 33
Figure 17.24A Positions for auscultation of the heart. A. Supine.
Slide 34 Figure 17.24B Positions for auscultation of the heart. B.
Lateral Slide 35 Figure 17.24C Positions for auscultation of the
heart. C. Sitting. Slide 36 Auscultation of Apical Pulse Specific
Areas of the Cardiovascular Assessment Auscultation of the carotid
arteries using the diaphragm and bell Comparison of the apical
pulse to a carotid pulse Slide 37 Figure 17.23 Comparing the
carotid and apical pulses. Slide 38 Abnormal Findings Abnormal
Findings in the Cardiovascular System Myocardial and pump disorders
Valvular disease Septal defects Congenital heart disease Electrical
rhythm disturbances Slide 39 Muscular and Pump Disorders Myocardial
and Pump Disorders Myocardial ischemia Myocardial infarction
Congestive heart disease Ventricular hypertrophy Slide 40 Valvular
Disorders Valvular Diseases Mitral, aortic, tricuspid, and pulmonic
stenosis Mitral and aortic regurgitation Mitral valve prolapse
Slide 41 Figure 17.25 Mitral stenosis. Slide 42 Figure 17.26 Aortic
stenosis. Slide 43 Figure 17.27 Mitral regurgitation. Slide 44
Figure 17.28 Pulmonic stenosis. Slide 45 Figure 17.29 Tricuspid
stenosis. Slide 46 Figure 17.30 Mitral valve prolapse. Slide 47
Figure 17.31 Aortic regurgitation. Slide 48 Setal Defects Septal
Defects Openings between the right and left atria or right and left
ventricles Slide 49 Figure 17.32 Ventricular septal defect. Slide
50 Figure 17.33 Atrial septal defect. Slide 51 Congenital Heart
Diseases Coarctation of the aorta Patent ductus arteriosus
Tetralogy of Fallot Slide 52 Figure 17.34 Coarctation of the aorta.
Slide 53 Figure 17.35 Patent ductus arteriosus. Slide 54 Figure
17.36 Tetralogy of Fallot. Slide 55 Figure 17.36 (continued)
Tetralogy of Fallot. Slide 56 Rhythm Disturbances Electrical Rhythm
Disturbances Ventricular tachycardia Ventricular fibrillation Slide
57 Figure 17.37 Ventricle tachycardia. Slide 58 Figure 17.38
Ventricular fibrillation. Slide 59 Figure 17.39 Heart block. Slide
60 Figure 17.40 Atrial flutter. Slide 61 Figure 17.41 Atrial
fibrillation. Slide 62 Developmental Considerations Pediatric Fetus
receives oxygen and nutrients from the mother Changes occur in the
newborn s cardiovascular system Infant s heart rate Slide 63
Developmental Considerations Pregnant Female Heart is displaced to
the left and upward Blood volume increases 30 to 50 percent Cardiac
output and stroke volume increase Resting pulse may increase
Murmurs may be auscultated Slide 64 Developmental Considerations
Geriatric Loss of ventricular compliance and vascular rigidity
Conduction system loses automaticity Slide 65 Psychosocial
Considerations Stress and workload of the heart Slide 66 Cultural
and Environmental Considerations Race Ethnicity Diet Substance
abuse Slide 67 Healthy People 2010 Focus Areas Outlined in the
Healthy People 2010 Coronary heart disease High blood cholesterol
Slide 68 Healthy People 2010 Key Objectives for Coronary Heart
Disease Reduce deaths Increase awareness of symptoms of heart
attack and the need for rapid emergency care Increase the numbers
of adults who can administer cardiopulmonary resuscitation Reduce
the number of obese individuals Increase physical activity Increase
the number of adults who are aware of risk factors and take action
to reduce risks Slide 69 Healthy People 2010 Key Objectives for
High Blood Cholesterol Reduce the number of adults with elevated
cholesterol levels Increase the number of adults who have
cholesterol levels measured
